Implementarea strategiei globale OMS pentru sectorul de sănătate privind hepatitele virale (2016-2021) printre copii și adolescenți în Republica Moldova

Abstract

Introduction. Chronic viral hepatitis continues to be in the 21st century the cause of one death every 8 minutes in the 21st century. In 2015 WHO, within the UN Sustainable Development Program, with the aim of saving 50 million human lives, comes with the initiative to approve a strategic action plan for implementation at the regional and country level. Guided by the European Regional Office of the WHO, in 2016, the Republic of Moldova elaborates the National Program against viral hepatitis B, C and D for 2017-2021, the achievements of which continue to be successfully implemented until now. The objective of the study. Presentation of the results of the implementation of the National Program against viral hepatitis B, C and D for 2017-2021 among children and adolescents and drawing new objectives for further effective monitoring. Results. The National Program against viral hepatitis B, C and D for 2017-2021 monitored 68 children. More than half of all assisted children (~53%) were affected by HCV, the remaining 47% developed chronic HBV hepatitis, of which almost one in three acquired either coinfection or superinfection and the Delta agent (HDV), constituting about 10% of all children with chronic viral hepatitis. About 7% of parents refused treatment for their children because of adverse reactions to pegylated interferon. Another 5% refused treatment due to migration. Almost every third child treated with pegylated inteferon combined with Ribavirin could not achieve a controlled viraemia. Conclusions. Since its inception, the National Program against viral hepatitis has provided antiviral treatment for 68 children. Adverse reactions to pegylated interferon did not keep viraemia under control and were the cause of discontinuation in more than 1/3 of those treated. The implementation of Tenofovir Disoproxil Fumarate and the extension of the age of administration to children over 3 years old, made it possible to reduce and almost exclude adverse reactions, better adherence to treatment and minimization of abandonment. Due to the continuity of policies against viral hepatitis even after the completion of the National Program, children in the Republic of Moldova can have access to therapy with direct antiviral preparations, provided by the state.